The significance of multidirectional studies in control of health care-associated infections

Abstract

Objective: With this study, it was aimed to research the implementations to prevent healthcare-associated infections (HAI) as well as their effectiveness in a private hospital in Turkey, where a high rate of HAI was reported with multidrug resistant pathogens. Methods: The study included all patients with HAI between January 1, 2011, and December 31, 2018. HAI rates were calculated according to the criteria of the Centers for Disease Control and Prevention. Infection control precautions were indicated by year. Results: HAI was detected in 252 patients throughout the study period. The most frequent HAI were health care-associated (HA) bloodstream infections (BSI) (33%), surgical site infections (SSI) (29%), urinary tract infections (UTI) (24%) and pneumonia (14%). 84.5% (71 out of 84) of HA-BSI was central line-associated (CLA) BSI and 15.5% of them was primary BSI; 96.7% of HA-UTI was catheter-associated UTI; 69.4% of HA pneumonia was ventilator-associated pneumonia (VAP), and 34.7% of SSI was superficial incisional, 11.1% was deep incisional, and 54.2% was organ/ space infections. VAP rate was 4.85 in 2011, and it was 0.11 in 2018; the rate of CLA-BSI was 2.32 in 2011, and 0.01 in 2017; in patients with hematologic diseases CLA-BSI was 3.39 in 2011 and it decreased to 0.55 in 2018. The most common detected pathogens were Staphylococcus spp. in HA-BSI, Pseudomonas spp. in VAP and Escherichia coli in CA-UTI. Conclusions: We significantly reduced the VAP and CLA-BSI in our hospital as a result of infection control methods considering the conditions in our country and hospital. We also put several unique implementations into practice to reduce the infections to a very low rate.